This technique which was introduced into the medical literature by Dr. Santoro is a surgical technique that limits both taking and absorption. The greatest advantage of this method above other bypass types is that the normal anatomic pathway is not disturbed and some of the nutrients continue to pass through the normal anatomical pathway. This case causes less vitamin and mineral deficiency on some patients. In the studies, no difference was found between this method and the tube stomach whether vitamin gap was seen or not.
Technically, in the first place, standard sleeve gastrectomy is performed but the left stomach capacity is a little larger. Then, starting from the beginning of the large intestine, it is counted backwards to the small intestines, it is cut an average of 250 cm. and connected to the lower edge of the stomach. The remaining part of the intestine is attached to the small intestine approximately 100 cm before the large intestine. In other words, a piece of intestine is not removed. In this case, an average of 1/3 of the foods continue on the normal route and the rest of them continue on the newly built passage.
This method seems to be a superior technique compared to sleeve gastrectomy for the control of Type II Diabetes in patients with sufficient pancreatic reserve. This method should be preferred especially for patients whose main problem is diabetes. The usage of this method in obesity surgery is limited. It may be a procedure that does not satisfy the patients who have desire to eat because thata causes foods’ passing into the intestine easily. 5-year results were published in 2012. Type II Diabetes is one of the methods that can be preferred safely in the surgical treatment. After this method as long as the patients apply the recommended treatment completely, 90% of the vitamin deficiencies will not be seen. One of its important advantages is that stomach leakages which are seen in sleeve gastrectomy operations are less since the stomach has 2 exits. One of its other important advantages is that every part of the stomach and duodenum can be seen endoscopically.
In the 5-year results of this surgical method, the patients lost 74% of their over weight and 86% were able to keep their blood sugar values under control without medication.